Sutured Intrascleral Posterior Chamber Intraocular Lens Fixation with Ciliary Sulcus Location Guided by Ultrasonic Biological Microscopy: A Retrospective Analysis of Anatomical and Refractive Outcome.

Ya Qu,Ping Duan,Shujia Huo,Jiawen Li,Fuliang Li

doi:10.1155/2020/5843410

Abstract

Purpose To report the outcome of sutured intrascleral posterior chamber intraocular lens (PC IOL) fixation with ciliary sulcus location guided by ultrasonic biological microscopy (UBM). Methods Patients who underwent a sutured intrascleral PC IOL fixation were reviewed and divided into four groups. In group 1, the traditional sulcus fixation (2 mm from limbus) of IOL was performed. In groups 2, 3, and 4, UBM was performed before surgery to locate the position of the ciliary sulcus as the haptics insertion position. IOL power was selected by decreasing the calculated value of the IOL power by 1.0 D, 1.0 D, 0.5 D, and 0.0 D, respectively. Results Sixty-one patients (63 eyes) were included in the four groups. After 4.1 ± 3.0 months' follow-up, the postsurgery spherical equivalent (SE) was 0.73 ± 1.86, 0.71 ± 0.84, 1.14 ± 0.45, and 0.07 ± 0.89 diopters (D), respectively. Statistical significance was reached for the postsurgery SE with target refraction between group 1 (p = 0.027, <0.05), group 2 (p = 0.003, <0.01), and group 3 (p = 0.017, <0.05). No significant difference existed for the postsurgery SE with target refraction in group 4 (p = 0.779, >0.05), and the postsurgery SE in group 4 was the nearest to target refraction. Conclusion Intrascleral PC IOL fixation guided by UBM is helpful for locating the ciliary sulcus and satisfactory visual outcomes with a predictable IOL power calculation.

Highlights

Implantation of an intraocular lens (IOL) in an eye without sufficient capsule support after vitrectomy can be accomplished by using an anterior chamber IOL, an iris-fixated IOL, a sutured or sutureless transscleral-fixated posterior chamber IOL (PC IOL), and transconjunctival intrascleral IOL [1, 2]. e sutureless intrascleral fixation technique of PC IOL has been the subject of a number of recent reports, and it is capable of obtaining a satisfactory effect [3,4,5,6]
We present our initial experience with the sutured intrascleral fixation technique of PC IOL under the guidance of ultrasonic biological microscopuy (UBM) involved in the ciliary sulcus location
UBM examination was performed on 43 patients (44 eyes) to locate the ciliary sulcus on sclera, and the distance from the corneal limbus to the ciliary sulcus at the 1 o’clock and 7 o’clock positions were recorded as the IOL haptic insertion points. e distance of ciliary sulcus on the sclera surface was 2.40 ± 0.26 mm at the 1 o’clock position

Summary

Introduction

Implantation of an intraocular lens (IOL) in an eye without sufficient capsule support after vitrectomy can be accomplished by using an anterior chamber IOL, an iris-fixated IOL, a sutured or sutureless transscleral-fixated posterior chamber IOL (PC IOL), and transconjunctival intrascleral IOL [1, 2]. e sutureless intrascleral fixation technique of PC IOL has been the subject of a number of recent reports, and it is capable of obtaining a satisfactory effect [3,4,5,6]. Implantation of an intraocular lens (IOL) in an eye without sufficient capsule support after vitrectomy can be accomplished by using an anterior chamber IOL, an iris-fixated IOL, a sutured or sutureless transscleral-fixated posterior chamber IOL (PC IOL), and transconjunctival intrascleral IOL [1, 2]. E sutureless intrascleral fixation technique of PC IOL has been the subject of a number of recent reports, and it is capable of obtaining a satisfactory effect [3,4,5,6]. We present our initial experience with the sutured intrascleral fixation technique of PC IOL under the guidance of ultrasonic biological microscopuy (UBM) involved in the ciliary sulcus location

Methods

Results

Discussion

Conclusion